Noninvasive angina management includes both lifestyle modification and drug therapy. Typically, the goals of angina treatment are to reduce symptom frequency and severity and to reduce the risk of myocardial infarction or cardiac death. In more severe cases that cannot be managed effectively through lifestyle and drug interventions, invasive procedures may be necessary. Lifestyle Modifications The following are lifestyle changes that can help patients manage angina: Slowing down. Performing tasks that evoke angina more slowly will reduce myocardial oxygen demand and help avoid higher exertion that can trigger symptoms. Reducing meal size. Patients should avoid eating large meals and instead eat smaller, more frequent meals. Avoiding stress. Patients should avoid situations that cause them stress. Stress management techniques to control anger and frustration can also help reduce angina symptoms. Improving physical conditioning. Improved physical conditioning can improve exercise tolerance and reduce the risk of cardiac death. Smoking cessation. Smoking reduces oxygenation of the blood. Quitting cigarettes will help increase oxygenation and generally reduce cardiac risk.	Patient Education, Reassurance, and Motivation Risk Factor Modification Angina Management
Drug Therapy Drug therapy is often used along with lifestyle modification to manage angina. The following medications are commonly used to treat angina: Nitrates. These fast-acting drugs that cause blood vessel dilation are generally taken at the onset of symptoms or prophylactically if a patient anticipates an anginal episode. Regular long-term use of nitrates can help reduce the frequency of angina. Beta-blockers. These agents slow the heart rate and reduce myocardial oxygen demand. Calcium-channel blockers. These are coronary vasodilators that reduce myocardial oxygen demand, contractility, and arterial pressure. ACE inhibitors. ACE inhibitors lower blood pressure and reduce strain on the heart. Antiplatelet drugs. These agents reduce blood clotting and can help prevent circulatory problems.
Management of Comorbid Conditions Medical conditions that can affect oxygen supply or demand, such as obesity, hypertension, and hyperthyroidism, may precipitate or aggravate angina. Effectively managing such conditions can also help to control angina.
Invasive Procedures If lifestyle and medical therapy are ineffective for managing anginal symptoms, invasive procedures may be necessary not only to relieve angina but also to prevent myocardial infarction. Angioplasty. Blocked or narrowed arteries are opened to improve blood flow, and a stent may be placed to help keep the vessels open. Coronary artery bypass grafting. Alternative veins or arteries are used to bypass the blocked or diseased vessels, improving blood flow.